Medicare Part D coverage · methylphenidate hydrochloride · RxCUI 1091389
methylphenidate hydrochloride 2.5 MG Chewable Tablet
Per the CMS 2026 Part D formulary file, methylphenidate hydrochloride 2.5 MG Chewable Tablet is covered by 1,596 Medicare Part D plans (31.6% of enrollable products), averaging Tier 2.7, with prior authorization required on 31.6% of covering formularies.
- 31.6%
- Plan coverage
- 1,596
- Plans covering
- T2.7
- Avg tier
- 31.6%
- Prior auth required
What the CMS Formulary Data Shows for methylphenidate hydrochloride 2.5 MG Chewable Tablet
Per the CMS 2026 Part D formulary file, methylphenidate hydrochloride 2.5 MG Chewable Tablet (RxNorm concept RXCUI 1091389, generic name methylphenidate hydrochloride) appears on 98 distinct formulary files spanning 1,596 Medicare Part D plan offerings - 31.6% of enrollable Part D products, selective placement; verify formulary inclusion before enrolling. Tier placement ranges from Tier 1 to Tier 4, with a cross-plan average of Tier 2.7.
Real-world access to methylphenidate hydrochloride 2.5 MG Chewable Tablet depends on utilization management as much as tier placement: 31.6% of covering formularies require prior authorization. 0% require step therapy. 69.4% apply quantity limits.
Historical spending context from the CMS Medicare Part D Drug Spending Dashboard shows 108,959 Part D beneficiaries filled methylphenidate hydrochloride 2.5 MG Chewable Tablet in 2023, with total plan-and-beneficiary spending of $18,053,775 and an average per-beneficiary annual cost of $165.69. The plan-by-plan detail below lists exactly which PDP and MA-PD contracts carry methylphenidate hydrochloride 2.5 MG Chewable Tablet today.
Coverage Details
- Formularies covering
- 98
- Plans covering
- 1,596
- Coverage rate
- 31.6%
- Tier range
- Tier 1 – Tier 4
- Average tier
- Tier 3, Preferred Brand
Restrictions
- Prior authorization required
- 31.6% of formularies
- Step therapy required
- 0% of formularies
- Quantity limits
- 69.4% of formularies
2023 Medicare Spending
- Beneficiaries
- 108,959
- Total spending
- $18,053,775
- Avg per beneficiary
- $165.69
Tier Distribution Across Plans
Medicare Advantage Plans (MA-PD) Covering methylphenidate hydrochloride 2.5 MG Chewable Tablet
100 Medicare Advantage plans with Part D drug coverage include this drug.
| Plan | Insurer | Tier | PA | Premium | States |
|---|---|---|---|---|---|
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T1 | Yes | $0 | FL |
| HealthSun MediMax (HMO) | Healthsun Health Plans, Inc. | T1 | Yes | $0 | FL |
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T1 | Yes | $0 | FL |
| HealthSun HealthAdvantage Plan (HMO) | Healthsun Health Plans, Inc. | T1 | Yes | $0 | FL |
| HealthSun MediSun Plus (HMO D-SNP) | Healthsun Health Plans, Inc. | T1 | Yes | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T1 | Yes | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T1 | Yes | $0 | FL |
| HealthSun MediSun Extra (HMO D-SNP) | Healthsun Health Plans, Inc. | T1 | Yes | $0 | FL |
| HealthSun HealthAdvantage Plus (HMO) | Healthsun Health Plans, Inc. | T1 | Yes | $0 | FL |
| HealthSun VitalCare (HMO C-SNP) | Healthsun Health Plans, Inc. | T1 | Yes | $0 | FL |
| HealthSun VitalCare (HMO C-SNP) | Healthsun Health Plans, Inc. | T1 | Yes | $0 | FL |
| HealthSun MediSun Full Dual Plus (HMO D-SNP) | Healthsun Health Plans, Inc. | T1 | Yes | $0 | FL |
| HealthSun MediSun Full Dual Extra (HMO D-SNP) | Healthsun Health Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Complete (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Complete (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
Show the next 30 plans
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Complete (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Level (HMO C-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Complete (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply More (HMO) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Extra (HMO) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Extra Platinum (HMO) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply More Platinum (HMO) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Complete Platinum (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Level Platinum (HMO C-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Extra Platinum (HMO) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Level Platinum (HMO C-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Extra Platinum (HMO) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Level Platinum (HMO C-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Extra Platinum (HMO) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply More Platinum (HMO) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Complete Platinum (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Level Platinum (HMO C-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Integrated (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Integrated (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Integrated (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Integrated (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Integrated (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Integrated (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Integrated (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Integrated Platinum (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
| Simply Integrated Platinum (HMO D-SNP) | Simply Healthcare Plans, Inc. | T1 | Yes | $0 | FL |
Showing top 50 of 100 plans.
Frequently Asked Questions
Is methylphenidate hydrochloride 2.5 MG Chewable Tablet covered by Medicare Part D?
Yes, methylphenidate hydrochloride 2.5 MG Chewable Tablet is covered by 1,596 Medicare Part D plans (31.6% of all Part D formularies).
What tier is methylphenidate hydrochloride 2.5 MG Chewable Tablet on Medicare Part D plans?
methylphenidate hydrochloride 2.5 MG Chewable Tablet averages Tier 2.7 across Part D plans, ranging from Tier 1 to Tier 4.
Does methylphenidate hydrochloride 2.5 MG Chewable Tablet require prior authorization?
31.6% of Part D formularies require prior authorization for methylphenidate hydrochloride 2.5 MG Chewable Tablet. Step therapy: 0%. Quantity limits: 69.4%.
How much does Medicare spend on methylphenidate hydrochloride 2.5 MG Chewable Tablet?
In 2023, total Medicare Part D spending on methylphenidate hydrochloride 2.5 MG Chewable Tablet was $18,053,775, covering 108,959 beneficiaries. The average spend per beneficiary was $165.69.
Read our methodology - how this data is sourced, computed, and verified.
Nationwide similar Part D drugs
Data-derived peers across the CMS Part D formulary extract: nearest average tier placement and nearest prior-authorization rate. Not therapeutic alternatives or same-generic strengths.
Closest average formulary tier
Similar prior-authorization rate
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